Inspection on 23/10/06 for Kingswood House

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingswood House 21/10/08

Kingswood House 13/12/05

Kingswood House 12/06/05

Kingswood House 10/11/04

Kingswood House 15/06/04

Kingswood House 16/07/02

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Kingswood House 21 - 23 Chapel Park Road St Leonards On Sea East Sussex TN37 7HR Lead Inspector Alexis Reilly Key Unannounced Inspection 23rd October 2006 9:00 Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingswood House Address 21 - 23 Chapel Park Road St Leonards On Sea East Sussex TN37 7HR 01424-716303 01424 423737 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Deirdre Hogan Mr Abraham Hogan Mrs Deidre Hogan Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23) of places Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twentythree (23) The service is for users thirty (30) years and over with continuing mental health care needs 13th December 2005 Date of last inspection Brief Description of the Service: Kingswood House is a 23 bedded home in St Leonards-on-Sea, situated approximately a quarter of a mile from both the railway station and the seafront. The Home is able to admit people aged 30 years or above and it specialises in supporting those with enduring mental health problems who require 24 hour nursing care. A range of shops is within easy walking distance and there is a nearby drop-in support centre for people with mental health issues. Kingswood House caters for diverse needs and promotes a lifestyle that supports residents to integrate into the community. Many are referred by forensic social workers. The Registered Manager who is also a part owner, is on shift during the day and qualified nurses take charge in her absence. The Home has steps up to the front entrance but also a sloped pathway and level access throughout the building, enabling wheelchair access. There is a passenger lift to all floors. The Home has 7 shared and 8 single rooms, all of which meet the space requirements laid down in the National Minimum Standard. Two lounges and a dining room provide communal space inside and at the back of the Home there is a patio area and large raised garden that can be accessed from both the dining room and the smokers’ lounge. The current e-mail address is Hogan@AOL.com. The current fee rate per week is between £400.00 and £950.00, there are additional charges for hairdressing, newspapers, holidays and some transport costs. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 9am and lasted for two and quarter hours. Further time was spent on preparing for the inspection and gaining the views of people who use the service. The following documents were examined on the inspection: Care Plans, risk assessments, and staff recruitment records. Records in relation to health and safety and training were sourced from the Pre Inspection Questionnaire. One new staff member had been recruited since the last inspection. The inspector spoke with one of the residents in private, and also spoke with a number in the home during the inspection. The proprietor of the home was also present during the inspection. Residents were seen in the home and appeared happy. Feedback was received from residents in the form of questionnaires, the comments of which are included in the report. Opinions of mental health professionals who have dealings with the home were also sort the comments are included in the report. Further time was taken in the preparation and writing of the report. What the service does well: What has improved since the last inspection? What they could do better: Individual interests, hobbies and emotional needs must be reflected in the resident’s care plans. Particular interests or hobbies should be identified as part of the pre-admission assessment. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 6 A copy of the Terms & Conditions of posts for employees and the appropriate Job Description should be retained on file. The main carpets in the hallways and bedrooms carpets on the two lower floors are in need of cleaning. However the proprietor informed the inspector this had been arranged for the coming week. Medication is distributed following the correct guidelines during the day, however the proprietors must ensure that the correct procedures are followed for dispensing evening medication in the home. In discussion with the Registered Manager they assured the Inspector that this would be investigated and would ensure that the correct procedures are followed for dispensing evening medication if this was not current practice. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. The service ensures it has gained the relevant background information for a resident prior to offering them a place in the service, and has assessed their individual needs. EVIDENCE: Kingswood House has a Statement of Purpose, which sets out the aims and objectives of the Home and the philosophy of care that is offered. Details of how complaints and concerns are managed and how to access advocacy services are included. The number of residents catered for and the categories of registration are also incorporated. There is a Service User guide providing a summary of the information in the Statement of Purpose. This and a Service User guide Statement of Terms & Conditions are given to each resident on arrival. The resident then signs and dates their terms of residency, indicating that they agree with them. The documentation has now been updated to include details of the Commission for Social Care Inspection and not the National Care Standards Commission. When an enquiry is made to the Home, prospective residents are invited to visit to view the available rooms and discuss the Home’s suitability. The Manager undertakes an assessment either at Kingswood House or in the resident’s current accommodation. Any preferences of specific minority ethnic communities or cultural/religious needs are explored as part of the assessment. If it appears the Home is suitable and can meet the needs of the Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 9 resident, they are then encouraged to visit and stay for periods, extending overnight if possible. The Registered Manager and other owner are both trained nurses in mental health; the other trained staff that are employed are general nurses with experience gained over several years at Kingswood House. All residents that are admitted have been diagnosed with mental health needs and some do have addictive behaviour - the Home requires a commitment from the resident to work in reducing that addiction. This discussion and agreement is part of the pre-admission assessment process. The agreement is then documented and the resident asked to sign, to demonstrate their aim to comply. The Home aims to take residents for long-term placement with rehabilitation rather than short-term care. The Proprietors have clear views around the consumption of alcohol on the premises and have policies in place to support this. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. The service creates plans of care for residents, and carries out comprehensive assessments. Within this framework residents are supported to take risks as part of an independent lifestyle. EVIDENCE: Each resident has a file containing their personal details; a history prior to admission, risk assessments and a care plan identifying their individual needs. The care plans prescribe the care required to ensure the essential aspects of health, personal and social needs are met. They are specific in detailing how each individual needs assistance and what care they are not able to provide for themselves. A daily record is then maintained detailing specific care or activities for each individual. Some residents belong to clubs and the inspector witnessed residents coming and going as they chose, on the day of inspection. Any restrictions are only put in place if it is in the resident’s best interest because they are at risk to themselves or others: where at all possible, there is negotiation and agreement, enabling residents to make decisions about their lifestyle. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 11 Individual hobbies and interests were not evident in the care plans and admission assessment. This was a requirement from the last inspection. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Service users take part in appropriate leisure activities, and access the local community. Appropriate relationships are encouraged, and service users enjoy their meals. EVIDENCE: Kingswood House struggles to engage residents in activities but they must continue to explore different alternatives and provide opportunities for structure in the residents’ day. Particular interests or hobbies should be identified as part of the pre-admission assessment. The Home works hard to encourage residents to go out with friends and also welcomes friends or relatives in joining in with meals and events. The staff recognise the importance of ensuring individual needs and beliefs are met, offering choice and flexibility for the routines of daily living. Friends are welcomed into the home during reasonable times, this is once residents are washed and have eaten their breakfast and are ready for the day normally after 10am. Family of residents are welcome at all times. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 13 Meal times within the home are as follows, breakfast is at 8.30am, tea and biscuits at 10.30am a hot lunch is served at 12 o clock, and tea and biscuits is served at 3pm, a hot supper at 8pm and a hot drink and biscuits at 10pm. If residents are going out for a purpose their meal will be kept. Alternatives are offered if they residents don’t like the main meal. A Jug of juice is left on the table in between drink times, and residents have access to drinks at all times of day. Some residents are risk assessed and have tea and coffee making facilities in their rooms. The inspector spoke with the cook in the home who confirmed fresh fruit and vegetables are always available and fruit and yoghurts are always available as alternatives to the main puddings. On the day of Inspection the atmosphere within the Home appeared happy and comfortable. Residents were choosing to spend time either in their own bedroom, in one of the two lounges, or they had chosen to go out into the town. During the tour of the Home, the Inspector witnessed the staff treating the residents with dignity and respect. All the rooms have locks and if appropriate following an assessment, residents have their own key. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Residents physical and mental health needs are monitored within the service. Residents are supported to remain well both physically and emotionally. Residents are protected by the homes policies on administration of medication. EVIDENCE: Staff are flexible and sensitive in the way they support residents, treating them with respect and maintaining their privacy. Health care needs appear to be met well and good practises are in place for the ordering, administration and disposal of medication. Medication is distributed following the correct guidelines during the day, however the proprietors must ensure that the correct procedures are followed for dispensing evening medication in the home. In discussion with the Registered Manager they assured the Inspector that this would be checked and would ensure that the correct procedures are followed for dispensing evening medication if this had lapsed. All the residents have a plan of care that identifies the areas of support or assistance that each individual needs. During the inspection residents were seen to be wearing their own clothes and reflecting their own personality. Residents are assisted with personal care if it has been assessed as being necessary. For those residents who are independent, the staff informally Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 15 monitor how they are caring for themselves. If their ability changes they are then re-assessed and the level of intervention is increased as necessary. Personal care is given in the privacy of an individual’s room or in the bathroom. All the residents have a key worker who they know and are happy with, and who oversees their plan of care. Health professionals are accessed as necessary and residents are accompanied to hospital appointments if needed. Residents are asked on admission as to whether they wish to administer their own medication or whether it is more appropriate for them to hand over the responsibility to the Home. If they wish to self medicate, a Risk Assessment is undertaken. Currently there are no residents who self medicate. The medication for the Home is kept in locked cupboards in the clinical room. All the medication is stored in measured doses for a 4-week period. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. The service has an accessible complaints procedure in place. Residents are listened to and complaints are taken seriously. The service has an up to date Adult Protection Policy. EVIDENCE: Adult Protection training is carried out by all staff following an in house training programme, this also applies to Protection of Vulnerable Adults training. The home ensures that Potential new staff members are checked against the Protection of Vulnerable Adults (POVA) register and Criminal Records Bureau (CRB) register. The Registered Provider confirmed that training in Protection of Vulnerable Adult is carried out on a regular basis and in accordance with the East Sussex County Council Multi-Agency Procedures – Protection of Vulnerable Adults guidelines. The service deals with complaints professionally and quickly and all complaints are taken seriously. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Residents have bedrooms decorated to their choice and live in a safe environment. EVIDENCE: Kingswood House provides accommodation for up to 23 residents. On the ground floor there is a lounge for those who prefer not to smoke and another lounge for smokers. There is also a dining room and a kitchen. There are then bedrooms on the first and second floor. All floors are serviced by a shaft lift, enabling access for those with limited mobility. There are toilets and two bathrooms in the Home: one bath has a ‘Parker’ bath enabling assisted bathing for those who are less mobile. The middle floor has now been redecorated, all bedrooms and hallways on the top two floors have been redecorated, new pine bedroom furniture has been installed in all bedrooms where residents have requested it, and the lift is now in full working order following a complete refurbishment. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Staff receive a variety of in house training in addition to the statutory training. Residents are protected by the homes recruitment procedures and staff supervision polices. EVIDENCE: The inspector examined the recruitment file of the newly recruited staff member on the day of the inspection all documents were in order, however the photo identification in the recruitment file was not available to view. The inspector was assured it was in place, the Manager must ensure a copy of photographic Identification is kept on the recruitment file and available to view during inspections. Staff within the service receive regular supervision once every two months. The home employees five first level registered nurses, eight care staff and two ancillary staff, two of these care staff have NVQ level 2 or above. Further training carried out in the last 12 months by staff is moving and handling and induction training. Further training planed for the coming months is one staff member to commence NVQ level 2, and an update of food hygiene training. First training for all staff is planned for November. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Resident’s views are taken into consideration within the home. EVIDENCE: The Proprietors who are also the Managers of Kingswood house are both Registered Mental Nurses who have a good relationship with the community mental health and forensic teams. This allows resident with complex needs to be placed and monitored and supported effectively. The Manager’s office door is always open and residents have access to them when ever they wish, this was very evident during the inspection as residents would come in and sit in the office and felt very comfortable doing so. Comments received from residents in the form of the surveys sent out by the Commission for Social Care Inspection confirmed that in the main people received sufficient information about the home prior to moving in to enable them to make a informed decision. That people knew who to talk to if they were unhappy and how to make a complaint. That the home is usually clean Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 20 and fresh and staff always treat them well, with someone always being available. Written comments from residents included the following ‘I feel the general health and welfare is very good’, ‘if I had a complaint I would make it to the staff in charge’, ’I have had no complaints in any way so far’, ‘The care is usually very well done’, ‘my health is looked after very well’, ‘ food is good’, ‘it seems a comfortable home to move into, it is good having staff in uniform because you feel help is near if I want it’, ‘I spent a lot of time visiting about nine times, some of those times I was able to sleep here’, ‘I can be forgetful so it helps when staff make appointments and remind me to do things’, ‘I have the staff at Kingswood to help, I can talk to my social worker or CPN who visits regularly’. The fire equipment manufacturers last check was in September 2006, the date of the most recent fire drill was June 2006, and the staff had fire training in May 2006, the fire alarms are tested weekly, the lift has been fully refurbished in October and is in full working order. The following policies are in place and have been reviewed in June 2006, Risk Assessment and Management, Sexuality and Relationships, Smoking and use of Alcohol and Substances by Users, Visitors and Staff, Staff Supervision, Values of Privacy Dignity, Choice, Fulfilment, and Independence. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 Regulation 16 (m)(n) Requirement Individual interests, hobbies and emotional needs must be reflected in the resident’s care plans. Thorough recruitment checks must be in place. Two written references must be obtained before appointing a member of staff and proof of ID, including a photo, must be kept on file. Timescale for action 01/12/06 2. YA34 19 Schedule 2 (1)(5) 01/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA14 YA34 Good Practice Recommendations Particular interests or hobbies should be identified as part of the pre-admission assessment. A copy of the Terms & Conditions of posts and the appropriate Job Description should be retained on file. Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingswood House DS0000014007.V315117.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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